Attachment device and system for corneal irrigating cannula and method thereof

ABSTRACT

A cannula support serves in supporting a cannula relative to a non-contact lens assembly and a positioning mechanism for positioning the non-contact lens assembly. The cannula support includes a cannula holder and a gripper disposed relative to the cannula holder. The cannula holder is provided for receiving at least a portion of the cannula. The gripper is adapted to cooperatively engage a portion of one of the non-contact lens assembly and the positioning mechanism.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to a eye surgery, and moreparticularly to surgical instrumentation and to a method for supportinga cannula relative to an eye in which the cannula can be actuated toirrigate the eye.

2. Description of the Prior Art

Traditionally, retinal surgeons relied on standard operating microscopesin conjunction with surgical contact lenses to view the interior of theeye. During use, the surgical contact lenses are held in place on thecorneal surface of the eye. However, even though the surgical contactlenses provided a clear view of the interior of the eye, such lensesafforded only a limited field of view. Moreover, given that the surgicalcontact lenses must be held in place on the corneal surface, retinalsurgeons were limited in their ability to manipulate the eye.

Binocular indirect ophthalmo microscopes (BIOMs) with wide-angle viewingsystems are commonly employed by retinal surgeons during posteriorsegment eye surgery. BIOMs with wide-angle viewing systems offersuperior functionality over standard operating microscopes used inconjunction with surgical contact lenses. BIOMs with wide-angle viewingsystems allow for a greater field of view and increased surgicalmobility. Rather than using surgical contact lenses, BIOMs withwide-angle viewing systems employ non-contact lens assemblies to viewthe interior of the eye. The non-contact lens assemblies includenon-contact lenses positioned along the focal axes of the BIOMs. Whenfocusing the BIOMs on the interior of the eye, the retinal surgeonadjusts and positions the non-contact lenses along the focal axes usingpositioning mechanisms.

To properly focus the BIOMs, the non-contact lenses must be positionedin close proximity to the eye. For example, the non-contact lenses areoften positioned less than one inch from the corneal surface. Duringsurgery, such close proximity to the corneal surface createsdifficulties in keeping the corneal surface wet and consequently clear.

Typically, surgical assistants assist the retinal surgeons duringsurgery, and are charged with irrigating the eye. In doing so, thesurgical assistants manually position and actuate a cannula to supplyfluid to the eye. The close proximity of the non-contact lens to the eyecan lead to unintentional wetting with fluid from the cannula whenattempting to the irrigate the eye. Such unintentional wetting can delaythe surgery until the non-contact lenses are cleaned or the non-contactlens assemblies are replaced. Moreover, because the surgical assistantsmust usually look up from oculars to manually position and actuate thecannula, there is also danger that manipulation of the cannula willdeleteriously interfere with the surgery.

Therefore, there exists a need for surgical instrumentation and a methodfor supporting a cannula relative to an eye in which the cannula can beactuated to irrigate the eye, while inhibiting unintentional wetting ofthe non-contact lens and deleterious interference with the surgery.

SUMMARY OF THE INVENTION

The present invention in one preferred embodiment contemplates a cannulasupport for supporting a cannula relative to a non-contact lens assemblyand a positioning mechanism for positioning the non-contact lensassembly, the cannula support includes a cannula holder, the cannulaholder receiving at least a portion of the cannula, and a gripperdisposed relative to the cannula holder, the gripper adapted tocooperatively engage a portion of one of the non-contact lens assemblyand the positioning mechanism.

The present invention in a further preferred embodiment contemplates anirrigation system for irrigating an eye during surgery, the irrigationsystem includes a cannula, and a cannula support including a cannulaholder, the cannula holder receiving at least a portion of the cannula,and a gripper disposed relative to the cannula holder, the gripperadapted to cooperatively engage a portion of one of a non-contact lensassembly and a positioning mechanism for positioning the non-contactlens assembly relative the eye, where the cannula can be actuated torelease a supply of fluid.

The present invention in another preferred embodiment contemplates apositioning and irrigating system for use during eye surgery, the systemincludes a non-contact lens assembly, a positioning mechanism forpositioning the non-contact lens assembly relative to the eye, acannula, and a cannula support including a cannula holder, the cannulaholder receiving at least a portion of the cannula, and a gripperdisposed relative to the cannula holder, the gripper adapted tocooperatively engage a portion of one of the non-contact lens assemblyand the positioning mechanism, where the cannula can be actuated torelease a supply of fluid.

The present invention in yet another preferred embodiment contemplates asurgical microscope assembly for use during eye surgery including asurgical microscope having a focal axis, a non-contact lens assembly, apositioning mechanism for positioning the non-contact lens along thefocal axis, a cannula, and a cannula support for supporting the cannula,the cannula support being attached to one of the non-contact lensassembly and the positioning mechanism.

The present invention also contemplates a method of irrigating an eyeduring eye surgery by providing a cannula support and a cannula having atip, fixing the position of a portion of the cannula with the cannulasupport, positioning the tip of the cannula adjacent the eye, andactuating the cannula to provide a supply of fluid to the eye.

The present invention further contemplates a method of performingsurgery on an eye by providing a surgical microscope having focal axis,positioning the eye along the focal axis, positioning a non-contact lensassembly between the eye and the surgical microscope, adjusting theposition of the non-contact lens assembly along the focal axis to focusthe surgical microscope on the eye, providing a cannula support, fixingthe position of a portion of a cannula adjacent the eye using thecannula support, and actuating the cannula to irrigate the eye with asupply of fluid.

It is understood that both the foregoing general description and thefollowing detailed description are exemplary and exemplary only, and arenot restrictive of the invention as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of the specification, illustrate preferred embodiments of theinvention. Together with the description, they serve to explain theobjects, advantages and principles of the invention. In the drawings:

FIG. 1 is a side elevational view of a surgical microscope systempositioned relative to an eye including a cannula support of the presentinvention;

FIG. 2 is an enlarged side elevational view of FIG. 1 showing thecannula support attached to a non-contact lens assembly;

FIG. 3 is a perspective view of the cannula support shown in FIGS. 1 and2 attached to the non-contact lens assembly;

FIG. 4 is a front elevational view of the cannula support shown in FIGS.1-3;

FIG. 4A is a front elevational view of the cannula support of FIGS. 1-3in another position;

FIG. 5 is a bottom plan view of the cannula support shown in FIGS. 1-4;

FIG. 6 is a front elevational view of an alternative embodiment of thecannula support of the present invention;

FIG. 7 is a front elevational view of another alternative embodiment ofthe cannula support of the present invention; and

FIG. 8 is a front elevational view of yet another alternative embodimentof the cannula support of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The following description is intended to be representative only and notlimiting and many variations can be anticipated according to theseteachings. Reference will now be made in detail to the preferredembodiments of this invention, examples of which are illustrated in theaccompanying drawings.

FIG. 1 shows a surgical microscope 10 used by an ophthalmologist inperforming eye surgery. Surgical microscope 10 includes a housing 12, anocular 14, and a lens 16. Lens 16 includes a vertically-oriented opticaxis 18 extending through a surgery area A. A patient is disposed insurgery area A, and, for illustrative purposes, a patient's eye E isshown in FIG. 1.

A positioning assembly 20 is attached adjacent lens 16. Positioningassembly 20 serves in positioning a non-contact lens assembly 22relative to surgical microscope 10. Non-contact lens assembly 22includes a non-contact lens B adapted to be positioned along optic axis18. Using positioning assembly 20, non-contact lens assembly 22 iscapable of vertical reciprocal movement relative lens 16 along opticaxis 18. In doing so, non-contact lens B can be positioned in variousvertical positions along optic axis 18 to focus surgical microscope 10.

Positioning assembly 20 includes a support arm 24 attached to housing 12adjacent lens 16. Support arm 24 supports the remainder of positioningassembly 20, and can be rotated relative to housing 12 to swingnon-contact lens assembly 22 into and out of position relative to opticaxis 18. Support arm 24 is detachable from housing 12. A guide 26 and aspindle 28 extend downwardly from support arm 24. Guide 26 is acylindrical rod, and spindle 28 is a threaded cylindrical rod. Astationary plate 30, oppositely disposed from support arm 24, isattached to guide 26 and spindle 28. Guide 26 fixedly attachesstationary plate 30 to support arm 24, and spindle 28 is rotatablebetween support arm 24 and stationary plate 30. Stationary plate 30supports an actuation mechanism 32 used in rotating spindle 28.

Actuation mechanism 32 operatively engages spindle 28 to provide forrotation thereof. Gears or belts and pulleys can, for example, be usedto operatively connect actuation mechanism 32 to spindle 28.Furthermore, actuation mechanism 32 is motivated by a drive shaft 34extending downwardly from a drive mechanism 36. As shown in FIG. 1,drive mechanism 36 is positioned on housing 12 away from surgery area A.When actuated, rotary movement is transferred from drive mechanism 36through drive shaft 36 to actuation mechanism 32. In turn, actuationmechanism 32 using the above-referenced gears or belts and pulleysserves to rotate spindle 28.

A movable plate 38 is adapted to receive guide 26 and spindle 28therethrough. Movable plate 38 is slidable along guide 26, andthreadingly engages spindle 28. Rotational movement of spindle 28 servesin repositioning movable plate 38 along guide 26 and spindle 28. Assuch, movable plate 38 is reciprocally moveable along guide 26 andspindle 28. Depending on whether spindle 28 is rotated clockwise orcounter-clockwise, movable plate 38 is moved in vertical directionsrelative to surgical microscope 10 and patient's eye E.

A telescoping support tube 40 having a first portion 41 and a secondportion 42 depends downwardly from moveable plate 38. First portion 41is fixedly attached to moveable plate 38, and second portion 42 ismoveable in and out of first portion 41. The movement of second portion42 relative to first portion 41 occurs vertically relative to surgicalmicroscope 10 and patient's eye E.

Non-contact lens assembly 22 is supported on second portion 42 oftelescoping support tube 40. Second portion 42 includes a coupler 44 towhich non-contact lens assembly 22 can be attached. Coupler 44 isadapted to allow non-contact lens assembly 22 to be detachabletherefrom. As such, a variety of mechanical fasteners can be used forcoupler 44. Being detachable allows non-contact lens assembly 22 to beinterchangeable. As such, non-contact lens assembly 22 can be exchangedwith other non-contact lens assemblies having non-contact lenses withdifferent focal lengths. Therefore, depending on the characteristics ofpatient's eye E, a non-contact lens B with an appropriate focal lengthcan be provided.

In addition to non-contact lens B, non-contact lens assembly 22, asshown in FIGS. 2 and 3, includes a flange 48 and a stem 50. Flange 48holds non-contact lens B, and stem 50 includes a first portion 51 and asecond portion 52. First portion 51 extends outwardly from flange 48,and second portion 52 is adapted to be attached to coupler 44. Thelength and angle of first portion 51 are provided so that, whenpositioning assembly 20 is properly positioned relative to surgicalmicroscope 10 and patient's eye E, optic axis 18 of surgical microscope10 passes through non-contact lens B.

FIGS. 2 and 3 show a cannula support 60 supporting a cannula 62 attachedto stem 50. Cannula 62 includes a proximal end portion 64, a distal endportion 65, and an intermediate portion 66 extending therebetween.Proximal end portion 64 is connected to a supply line 68 fluidlycommunicating with a reservoir 70, and distal end portion 65 includes atip T. Tip T can be formed at a perpendicular angle or anon-perpendicular angle to the remainder of cannula 62. As such, tip Tcan be formed at an angle such that it is oriented away from non-contactlens assembly 22.

Cannula 62 is formed from flexible tubing made from, for example,silicon, vinyl, or polyethylene. Cannula 62 can include an internal orexternal support structure allowing the position of distal end portion65 to be adjusted and, thereafter, maintained relative to patient's eyeE. To that end, a malleable sleeve 72, for example, can be providedaround a portion of distal end portion 65. To limit damage to patient'seye E due to contact with cannula 62, malleable insert 72 is displacedat least two (2) mm from tip T. Malleable insert 72 can be adjusted tomove distal end portion 65 and tip T between various positions. When aposition is selected, malleable insert 72 serves in maintaining distalend portion 65 and tip T in that position. As such, once distal endportion 65 and tip T are positioned adjacent patient's eye E, cannula 62can be actuated to supply fluid from reservoir 70 to irrigate patient'seye E.

FIG. 4 shows cannula support 60 including a base portion 74, and firstand second arms 76 and 78. FIG. 5 shows cannula support 60 includingfirst and second cannula holders 80 and 81 to receive a least a portionof cannula 62. Cannula holders 80 and 81 are attached or otherwisesecured to base portion 74, and are used to receive cannula 62. Cannulaholders 80 and 81 can, for example, be substantially cylindrical tubularmembers for receiving cannula 62 therein. Although two cannula holdersare shown in FIG. 5, more than two cannula holders or as few as onecannula holder can be used to hold cannula 62. Cannula holders 80 and 81are shown having continuous perimeters, however, one or more cannulaholders having interrupted perimeters (FIG. 6) can be used to holdcannula 62.

First and second arms 76 and 78, together with base portion 74, form agripper 82. Gripper 82 serves in attaching cannula holder 60 to firstportion 51 and/or second portion 52 of stem 50. First and second arms 76and 78 each include first and second arm portions 84 and 86 giving firstand second arms 76 and 78 L-shaped cross-sections (FIG. 4). Furthermore,a retention space S1 for receiving a portion of stem 50 is definedbetween second arm portions 86 and base portion 74, and first armportions 84 of first and second arms 76 and 78 are pivotably connectedto sides of base portion 74.

During use of gripper 82, first and second arms 76 and 78 can be pivotedrelative to base portion 74 between a first position P1 (FIG. 4) and asecond position P2 (FIG. 4A). First and second arms 76 and 78 are biasedtoward first position P1. Therefore, by pressing inwardly on first armportions 84, first and second arms can be repositioned from firstportion P1 to second position P2. In first position P1, second armportions 86 are aligned with base portion 74. In second position P2,second arm portions 86 are angled relative to one another and baseportion 74 to provide access to retention space S1 for receiving aportion of stem 50 therein. For example, to attach cannula support 60 tostem 50, first portion 51 and/or second portion 52, when first andsecond arms 76 and 78 are in second position P2, are received inretention space S1. Thereafter, when first arm portions 84 are released,and first and second arms 76 and 78 return to first position P1,retention space S1 closes around first portion 51 and/or second portion52. In doing so, first and second arms 76 and 78 serve to attach cannulasupport 60 to stem 50.

FIG. 6 shows an alternative embodiment of the cannula support generallyreferred to by the numeral 90. Cannula support 90 includes a baseportion 92, a cavity 94 formed in base portion 92, and a cannula holder96 attached or otherwise secured to base portion 92. Cannula holder 96is used to hold cannula 62 and includes an interrupted perimeter.Although cannula holder 96 can be provided with a continuous perimeter,the interrupted perimeter can in some applications provide increasedfunctionality. For example, when cannula holder 96 is composed of aresilient material, the interrupted perimeter of cannula holder 96permits cannula 62 to be pressed into position therein by allowing thesidewalls thereof to flex. Furthermore, although one cannula holder 96is shown in FIG. 6, two or more such cannula holders can be provided tohold cannula 62.

Cavity 94 serves as a gripper for attaching cannula support 90 to stem50, and is itself a retention space for receiving at least a portion ofstem 50. To attach cannula support 90 to stem 50, second portion 52 andthen, if necessary, first portion 51 can be inserted into cavity 94. Assuch, cannula 90 can be attached to stem 50 by receiving first portion51 and/or second portion 52 in cavity 94. Furthermore, although FIG. 6shows cavity 94 having a continuous perimeter, a cavity having aninterrupted perimeter can be provided.

FIG. 7 shows another alternative embodiment of the cannula supportgenerally indicated by the numeral 110. Cannula support 110 includes abase portion 112, a gripper 114, and a cannula holder 116 attached orotherwise secured to base portion 112. Cannula holder 116 is used tohold cannula 62 and includes a continuous perimeter. However, likecannula holder 96, cannula holder 116 can have an interrupted perimeter.Furthermore, although one cannula holder 116 is shown in FIG. 7, two ormore such cannula holders can be provided to hold cannula 62.

Gripper 114 comprises base portion 112 and first and second arms 118 and119, and is used for attaching cannula support 110 to stem 50. Baseportion 112 and first and second arms 118 and 119 define a retentionspace S2 for receiving at least a portion of stem 50. First and secondarms 118 and 119 are biased in an initial position (FIG. 7), and aremoveable from the initial position to an outwardly deflected positionproviding access to retention space S2. For example, first and secondarms 118 and 119 are formed of a resilient material, and inclinedprojections 120 are provided on the ends of first and second arms 118and 119 opposite base portion 112. To attach cannula support 90 to stem50, first portion 51 and/or second portion 52 are initially contactedagainst inclined projections 120. Contact of first portion 51 or secondportion 52 with inclined projections 120 cause first and second arms 118and 119 to deflect apart from one another to the outwardly deflectedposition, and, in doing so, provide access to retention space S3. Whenfirst portion 51 and/or second portion 52 are moved past inclinedprojections 120 and received in retention space S2, first and secondarms 118 and 119 return to the initial position, and first portion 51and/or the second portion 52 are held in position against base portion112 by inclined projections 120.

FIG. 8 shows yet another alternative embodiment of the cannula supportgenerally indicated by the numeral 130. Cannula support 130 includes abase portion 132, a gripper 134, and a cannula holder 136 attached orotherwise secured to base portion 132. Cannula holder 136 is used tohold cannula 62 and includes a continuous perimeter. However, likecannula holder 96, cannula holder 136 can have an interrupted perimeter.Furthermore, although one cannula holder 136 is shown in FIG. 8, two ormore such cannula holders can be provided to hold cannula 62.

Gripper 134 comprises first and second arms 138 and 139, and baseportion 132 which is u-shaped. U-shaped base portion 132 includes firstand second legs 140 and 141, and a retention space S3 for receiving atleast a portion of stem 50 is defined between first and second legs 140and 141. First and second arms 138 and 139, and first and second legs140 and 141 are biased in an initial position (FIG. 8), and are moveablefrom the initial position to deflected positions. First and second arms138 and 139 are deflectable toward one another, and first and secondlegs 140 and 141 are deflectable away from one another.

To attach cannula support 90 to stem 50, first portion 51 and/or secondportion 52 can possibly be slid into retention space S3. However, firstand second arms 138 and 139, and first and second arms 140 and 141 areformed of a resilient material. Therefore, to provide additional accessto retention space S3, first and second legs 140 can be moved away fromone another to an outwardly deflected position by pinching first andsecond arms 138 and 139 together. Thereafter, once first portion 51and/or second portion 52 is received in retention space S3, first andsecond arms 138 and 139 are released, and first and second legs 140 and141 return to the initial position, and, in doing so, contact firstportion 51 and/or second portion 52.

During surgery, the patient and his or her eye E, as shown in FIG. 1, ispositioned within surgery area A along optic axis 18 of surgicalmicroscope 18. Non-contact lens assembly 22 is moved relative tosurgical microscope 10 and patient's eye E using positioning assembly20. In doing so, positioning assembly 20 adjusts the position ofnon-contact lens B along optic axis 18 to focus surgical microscope 10.Cannula supports 60, 90, 110, and 130 can be attached to stem 50 ofnon-contact lens assembly 22 before or after non-contact lens assembly22 is properly positioned relative to surgical microscope 10 andpatient's eye E. Cannula supports 60, 90, 110, and 130 serve in fixingthe position of at least a portion of cannula 62 relative to non-contactlens assembly 22, and, hence, also surgical microscope 10 and patient'seye E. Malleable insert 72 can then be used to maintain tip T of cannula62 in close proximity to patient's eye E. Once properly positioned,cannula 62 can be actuated to provided a supply of fluid to irrigatepatent's eye E.

Other embodiments of the invention will be apparent to those skilled inthe art from consideration of the specification and practice of theinvention disclosed herein. It is intended that the specification andexamples be considered as exemplary only, with a true scope and spiritof the invention being indicated by the following claims.

1. A cannula support or supporting a cannula relative to a non-contactlens assembly and a positioning mechanism for positioning thenon-contact lens assembly, the cannula support comprising: a cannulaholder, said cannula holder receiving at least a portion of the cannula;and a gripper disposed relative to said cannula holder, said gripperadapted to cooperatively engage a portion of one of the non-contact lensassembly and the positioning mechanism, said gripper having at least onearm depending from said cannula holder, said at least one arm adapted tohold the portion of one of the non-contact lens assembly and thepositioning mechanism.
 2. The cannula support of claim 1 in combinationwith a cannula, wherein said cannula can be actuated to release a supplyof fluid.
 3. The combination according to claim 2, wherein said cannulaincludes a tip positionable relative to the non-contact lens assembly.4. The combination according to claim 3, wherein said cannula includes alongitudinal axis, and said tip is formed in a plane non-perpendicularto said longitundinal axis.
 5. The combination according to claim 4,wherein said tip is oriented away from the non-contact lens assembly. 6.The combination according to claim 2, wherein said cannula comprises aflexible tube and one of a malleable insert provided therein and amalleable sleeve provided thereon, said flexible tube having a tip, andsaid malleable insert and said malleable sleeve serving to maintain theposition of said tip relative to the non-contact lens assembly.
 7. Thecannula support according to claim 1, wherein said gripper defines acavity for receiving one of the non-contact lens assembly and thepositioning mechanism.
 8. The cannula support according to claim 7,wherein said gripper is moveable between an open position and a closedposition, and, when in said open position, said cavity is adapted toreceive the portion of one of the non-contact lens assembly and thepositioning mechanism.
 9. The cannula support according to claim 7,wherein said gripper is moveable between an open position and a closedposition, and, when in said closed position, said gripper is adapted toretain the portion of one of the non-contact lens assembly and thepositioning mechanism in said cavity.
 10. The cannula support of claim 1in combination with a non-contact lens assembly, wherein the cannulasupport is attached to said non-contact lens assembly.
 11. Thecombination according to claim 10, further in combination with amicroscope adapted for eye surgery and a positioning mechanism forpositioning said non-contact lens assembly relative to said microscope.12. The cannula support of claim 1 in combination with a positioningmechanism, wherein the cannula support is attached to said positioningmechanism.
 13. The combination according to claim 12, further incombination with a microscope adapted for eye surgery and a non-contactlens assembly, wherein said positioning mechanism serves in positioningsaid non-contact lens assembly relative to said microscope.
 14. Anirrigation system for irrigating an eye during surgery, the irrigationsystem comprising: a cannula; and a cannula support comprising a cannulaholder, said cannula holder receiving at least a portion of the cannula,and a gripper disposed relative to said cannula holder, said gripperadapted to cooperatively engage a portion of one of a non-contact lensassembly relative the eye, said gripper having at least one armdepending from said cannula holder, said at least one arm adapted tohold the portion of one of the non-contact lens assembly and thepositioning mechanism, wherein said cannula can be actuated to release asupply of fluid.
 15. A positioning and irrigating system for use duringeye Surgery, the system comprising: a non-contact lens assembly; apositioning mechanism for positioning said non-contact lens assemblyrelative to the eye; a cannula; and a cannula support comprising acannula holder, said cannula holder receiving at least a portion of thecannula, and a gripper disposed relative to said cannula holder, saidgripper adapted to cooperatively engage a portion of one of thenon-contact lens assembly and the positioning mechanism, said gripperhaving at least one arm depending from said cannula holder, said atleast one arm adapted to hold the portion of one of the non-contact lensassembly and the positioning mechanism, wherein said cannula can beactuated to release a supply of fluid.
 16. A surgical microscopeassembly for use during eye surgery, comprising: a surgical microscopehaving a focal axis; a non-contact lens assembly; a positioningmechanism for positioning the non-contact lens along the focal axis; acannula; and a cannula support for supporting said cannula, said cannulasupport being attached to one of said non-contact lens assembly and saidpositioning mechanism, said cannula support including a gripper havingat least one arm depending from said cannula holder, said at least onearm adapted to hold the portion of one of the non-contact lens assemblyand the positioning mechanism.